Patients’ perspectives on video consultation for non-communicable diseases: a qualitative study in Singapore

Abstract

Background: The COVID-19 pandemic increased the use of telemedicine in primary care services. Understanding patients' perspectives on telemedicine is pivotal for its wider adoption in managing non-communicable diseases (NCDs) in the community. Aim: To explore the views and concerns of patients who have yet to use video consultation (VC) for NCD management in Singapore. Design & setting: This qualitative study was conducted in a primary care clinic in Singapore. Method: In total, 16 patients participated in individual in-depth interviews. The participants had type 2 diabetes mellitus and/or hypertension and/or hyperlipidaemia without prior VC experience. They were purposively enrolled in the polyclinic. Audited transcripts were independently coded by two investigators. Thematic analysis was performed to identify perspectives on telemedicine based on the health, information, and technology zones of the Health Information Technology Acceptance Model. Results: The following three themes emerged: perceived benefits of VC utility; perceived barriers of VC adoption; and potential challenges of VC. Participants viewed VC as safe and convenient if they had stable NCD. They voiced concerns on possible suboptimal care owing to the absence of physical examination, network connectivity, and personal medical data security. Participants highlighted challenges of VC uptake such as digital health familiarity, availability of their own mobile and telemonitoring devices, and healthcare costs consideration. Conclusion: Addressing the concerns and challenges highlighted by non-VC users can help physicians and policymakers explore ways to scale up telemedicine in Singapore. A hybrid clinical care model comprising in-person visits and VC may be the way forward for NCD management.